Diabetes, Obesity & Metabolism · Oct 27, 2026

Efficacy and Safety of CagriSema in Type 2 Diabetes: A Dose- and Comparator-Specific Systematic Review and Bayesian Meta-Analysis

By Kow CS, Zaihan AF, Ramachandram DS et al.

BACKGROUND: CagriSema combines cagrilintide with semaglutide and may improve glycaemic control and body weight in Type 2 diabetes. We evaluated its dose- and comparator-specific efficacy and safety. METHODS: PubMed, Embase, CENTRAL and ClinicalTrials.gov were searched through 30 June 2026 for randomized controlled trials. Analyses were stratified by CagriSema dose and comparator. For HbA1c and body weight, efficacy/trial-product estimands were aligned where sufficiently reported, with treatment-policy estimates examined in sensitivity analyses. Bayesian random-effects models generated posterior medians and 95% credible intervals (CrIs). RESULTS: Six trials representing 4554 potentially eligible participants with Type 2 diabetes were included. Compared with placebo, CagriSema 2.4 mg produced between-group differences of -1.87 percentage points in HbA1c (95% CrI, -2.08 to -1.62) and -12.69 percentage points in percentage body-weight change (95% CrI, -13.78 to -11.61). Versus semaglutide 2.4 mg, the additional HbA1c reduction was modest and uncertain (-0.21 percentage points; 95% CrI, -0.62 to 0.11), whereas additional body-weight reduction remained probable (-5.84 percentage points; 95% CrI, -10.08 to -2.15). Gastrointestinal adverse events and adverse-event-related discontinuation were increased versus placebo (RR, 2.27 [95% CrI, 1.81 - 3.00] and 3.16 [1.50 to 6.87], respectively), while estimates versus semaglutide were less precise. CONCLUSIONS: CagriSema provides substantial glycaemic and body-weight benefits versus placebo. Its incremental advantage over dose-matched semaglutide is more evident for body-weight reduction, while comparative gastrointestinal tolerability and discontinuation risk remain uncertain.

doi.org/10.1111/dom.71485 Open access PubMed 42935221 Interventions